I recently read something about the commercial surgery called "ETS" which is used to cure excessive sweating in the hands amongst other things. I then realized Delic had this surgery, which shocked me. The surgery is very effective in stopping sweating in the hand and other areas, but it is very drastic in the sense that it destroys a large part of the autonomic nervous system in the body, which has effects on a very large number of organs and body parts, most of them negative. Especially for a sportsman it may cause problems. I hope this is not the case for Amer because that would be some nasty shit to take.

I recently read something about the commercial surgery called "ETS" which is used to cure excessive sweating in the hands amongst other things. I then realized Delic had this surgery, which shocked me. The surgery is very effective in stopping sweating in the hand and other areas, but it is very drastic in the sense that it destroys a large part of the autonomic nervous system in the body, which has effects on a very large number of organs and body parts, most of them negative. Especially for a sportsman it may cause problems. I hope this is not the case for Amer because that would be some nasty shit to take.

Yeah the post just made me read a little bit about it and it does seem pretty nasty and has even been banned in some countries.

My understanding is that ETS is only used as a last resort and that most of the drawbacks/risks occur at the time of the surgery. I have yet to read about any long term risks and it DOES NOT destroy "a lot of the autonomic nervous system". It is microsurgery and typically only involves destroying one to two levels of the thoracic sympathetic chain.
It has been used for over a decade with excellent results and minimal acute complications. No where in my reading did I read about any longterm complications that would hurt a sportsman.
I am sure Amer was counseled properly.

My understanding is that ETS is only used as a last resort and that most of the drawbacks/risks occur at the time of the surgery. I have yet to read about any long term risks and it DOES NOT destroy "a lot of the autonomic nervous system". It is microsurgery and typically only involves destroying one to two levels of the thoracic sympathetic chain.
It has been used for over a decade with excellent results and minimal acute complications. No where in my reading did I read about any longterm complications that would hurt a sportsman.
I am sure Amer was counseled properly.

From reading Amer's blog/website he was well aware of possible negative side-effects so it was a conscious decision to have the surgery.

There have been very few thorough medical studies on the subject. The surgery is notable for commercial private doctors in the US that have been actively solliciting patients. There has been a backlash against this surgery by people who suffered long-term side-effects that have started a large number of "warning/support" websites against ETS with full description of the long-term negative side-effects.

The Swedish doctor who pioneered the surgery stopped doing it and has now dedicated his career to tying to help people who suffer long-term side effects, and it has been banned in Sweden.

When thinking of possible drawbacks to a sportsman, I am considering for example the fact that the surgery destroys the sympathetic autonomic nervous system connection to the heart, which could interfere with the regulation of heart rate for excersize (sprints etc).

From reading Amer's blog/website he was well aware of possible negative side-effects so it was a conscious decision to have the surgery.

There have been very few thorough medical studies on the subject. The surgery is notable for commercial private doctors in the US that have been actively solliciting patients. There has been a backlash against this surgery by people who suffered long-term side-effects that have started a large number of "warning/support" websites against ETS with full description of the long-term negative side-effects.

The Swedish doctor who pioneered the surgery stopped doing it and has now dedicated his career to tying to help people who suffer long-term side effects, and it has been banned in Sweden.

When thinking of possible drawbacks to a sportsman, I am considering for example the fact that the surgery destroys the sympathetic autonomic nervous system connection to the heart, which could interfere with the regulation of heart rate for excersize (sprints etc).

Actually many of the centers I know about are in academic centers with a long history of performing the surgery. I am always leary of so called "warning websites" in this regard. And the surgery when done right only cuts off the
thoracic sympathetic chain number 3 and rarely also number 4. This of itself should not affect the heart rate. Since I am well aware of how the medical system in this country works; I am extremely doubtful that any surgeon would ever perform this on anyone in this present climate of " sue the bastard" here in the states let alone on a sportsman. Not sure I understand where you get your information. Anyway I am quite done on this subject

Actually many of the centers I know about are in academic centers with a long history of performing the surgery. I am always leary of so called "warning websites" in this regard. And the surgery when done right only cuts off the
thoracic sympathetic chain number 3 and rarely also number 4. This of itself should not affect the heart rate. Since I am well aware of how the medical system in this country works; I am extremely doubtful that any surgeon would ever perform this on anyone in this present climate of " sue the bastard" here in the states let alone on a sportsman. Not sure I understand where you get your information. Anyway I am quite done on this subject

Well, I admit to using Wikipedia's description, which certainly suggests that the surgery is not without controversy and there is a difference of opinion even in the medical field. When performed by academic centers on delibitated patients (who suffer from severe social/psychological problems associated with hyperhidrosis or social fobia) certainly I can imagine that the positive effects of the surgery far outweigh the negative. But it doesn't quite seem to be the minor surgery with limited side-effects that is sometimes portrayed.

The history of medicine is filled with treatment strategies and methods that at one time were considered benign and highly effective and later discredited. I'm not saying ETS is all bad, but there's certain reason for caution.

Since I am well aware of how the medical system in this country works; I am extremely doubtful that any surgeon would ever perform this on anyone in this present climate of " sue the bastard" here in the states let alone on a sportsman.

I think the surgery at the moment has an "approval" rating for certain indications by the governmental medical authorities in the US, and is generally reimbursed and covered by insurance. As long as a doctor documents a condition for which the surgery is officially indicated among his patients, he will feel legally protected since most of the blame would fall on the authorities in the event of a legal backlash.

Well, no, people here still go after the doctor too, if anything happens

Yes, I did have the impression that lawyers and lawsuits are 10x-100x more common in the US compared to Europe for example. But I think what it is issue here is primarily vague long-term complications (5-20 years) rather than immediate complications due to surgery. In Sweden the surgery was introduced 10-15 years before the US and there was a lot more experience with long-term side-effects and patient satisfaction and subsequent controversy and eventually outlawing of the surgery. If the Swedish experience is anything to go by I suspect in 5 to 15 years there will be more controversy and litigation related to the long-term effects of the surgery in the US, especially related the subset of doctors that are actively commercializing and soliciting patients for the surgery.

I think the surgery at the moment has an "approval" rating for certain indications by the governmental medical authorities in the US, and is generally reimbursed and covered by insurance. As long as a doctor documents a condition for which the surgery is officially indicated among his patients, he will feel legally protected since most of the blame would fall on the authorities in the event of a legal backlash.

You obviously do not live in the US nor are you part of the medical system.
Doctors get sued and lose all the time even when the case is poorly substantiated.

Yes, I did have the impression that lawyers and lawsuits are 10x-100x more common in the US compared to Europe for example. But I think what it is issue here is primarily vague long-term complications (5-20 years) rather than immediate complications due to surgery. In Sweden the surgery was introduced 10-15 years before the US and there was a lot more experience with long-term side-effects and patient satisfaction and subsequent controversy and eventually outlawing of the surgery. If the Swedish experience is anything to go by I suspect in 5 to 15 years there will be more controversy and litigation related to the long-term effects of the surgery in the US, especially related the subset of doctors that are actively commercializing and soliciting patients for the surgery.

I forget exactly, but I believe it was Germany that is even more litigious than the US. the US is bad for some things, but not for others, so you can't lump all of Europe together Sweden functions in a very different way from the US legally-speaking (and i'm sure medically-speaking), so I dunno if you can draw too many parallels. You may very well be right but it's impossible to say.

Quote:

Originally Posted by cobalt60

You obviously do not live in the US nor are you part of the medical system.
Doctors get sued and lose all the time even when the case is poorly substantiated.

I forget exactly, but I believe it was Germany that is even more litigious than the US. the US is bad for some things, but not for others, so you can't lump all of Europe together Sweden functions in a very different way from the US legally-speaking (and i'm sure medically-speaking), so I dunno if you can draw too many parallels. You may very well be right but it's impossible to say.

No need for a hug here; I have never been sued The best defense against a lawsuit is having a very strong bond/relationship with your patients; and knowing what the hell you are doing